There are over 700,000 Americans with severe physical impairments (SPIs) who have few options for independently accessing telecommunication services such as voice calls, text messaging, and video calling. The inability to independently and reliably access these services impacts many aspects of their lives. Nurturing friendships becomes more difficult, it is practically impossible to meet new social and professional norms for communicating or to manage personal care assistants and medical needs, and independent access to emergency services is often not possible. Perhaps even more devastating is the impact on self-image and mental health. There is a critical distinction between having a physical impairment and having a disability. It is the inability to participate in lifestyle factors, including community connections and social networks, that makes someone disabled. Assistive technology, when implemented well, can remediate a disability caused by physical impairment and help people to participate more fully in society through improved relationships and service to others. We propose to create an accessible telecom system that provides independent and reliable access to landline, cellphone, and internet-based voice, text, and video communication to the extent allowed by the local telecom infrastructure. Our team will accomplish this by creating an accessible VoIP phone for Windows-based computers optimized for control by assistive technology. This phone will provide access to voice, video, instant messaging, and SMS (short message service) texting. To address the needs of people who do not have access to high-speed internet (either because of limitations due to positioning or internet service limitations), we will also create an accessible Bluetooth speakerphone that will enable voice access to landline and cell phones. Feasibility of this new telecom system will be demonstrated by recruiting nine adults with SPI to test the system for a 2-month in-home trial period. We will recruit three participants whose primary telecommunications medium will be high speed internet, three whose primary communications medium will be their household landline, and three who will use a cellphone. We predict that these adults will be able to independently and reliably access available telecom services, and that their competence, adaptability, and self- esteem will improve. Participants will be recruited from InvoTek's regional network of people with disabilities.